Phrases to Avoid When Talking to Someone with Dementia

Our Guest Blogger, Rachael Wonderlin, MS, is a dementia care consultant living in Pittsburgh, PA. She runs a blog, Dementia By Day, and wrote a book called, “When Someone You Know is Living in a Dementia Care Community,” published by Johns Hopkins University Press.

“Honey, it was great visiting with you this afternoon,” Mel offered, kissing his wife goodbye. “I’ll come back tomorrow. It’s getting late and I want to make sure I get home,” he said.

“Great,” Beverly smiled back. “Let’s go home now.”

Mel stopped in his tracks at the door. “No, honey, I have to go home…you stay here. This is where you live now!”

Beverly was shocked. “What do you mean, Mel? You said it’s time to go home, now let’s go!”

I had watched this interaction far too many times, too many days in a row. The couple would have a nice afternoon, he’d go to leave, they’d argue, and then Beverly would spend the rest of the day in tears. It was completely unproductive and would ruin all the positive feelings that they’d amassed together earlier in the day.

I’d also done my best to counsel Mel about what to say instead of, “I’m going home” and, “This is where you live now,” but it was to no avail. Mel insisted on “telling his wife the truth” about where he was going and why. Upon hearing that he was going home, though, Beverly did what anyone would do: pick up her purse and get ready to leave with her spouse!

Mel had encountered a typical dementia-related problem: when caregivers use logic to try and convince someone living with dementia of a fact. Often, they’d end up back in her room—the one she shared with her assisted living roommate—and he would point out items. “Doesn’t this look familiar?” he’d ask. “See, you recognize this, right? This must be where you live now, then.”

This argument was logical, but it just didn’t make sense to someone like Beverly. Dementia is an umbrella term for cognitive loss caused by many different diseases, all of which cloud someone’s ability to understand, reason, judge, and comprehend. So, when presented with logical facts, a person living with dementia is unable to apply them. Instead, they just get upset and confused.

Here are a few phrases we want to avoid and some phrases we could use, instead:

• “I’m going home.” - The word “home” is a trigger for all of us. When we hear “home,” we think of a specific place. Maybe we even have a feeling or two that the word evokes. When someone living with dementia hears you’re going home, they probably assume that they’ll be joining you. They no longer recognize where they are living as their home. Instead of saying, “I’m going home,” try, “I’m running out for a bit, I’ll be back later.” And it’s true: you will be back later to see them.

• “You live here now.” - The person you’re speaking to probably does not recognize that where they are now is where they are actually living. They believe they’re just there visiting, or maybe they think it’s just temporary. The phrase, “you live here now,” invokes feelings of permanency, which is probably quite confusing. Instead, let’s try, “The doctor wants you to stay here until your walking is better,” or, “You’ll be able to go back home soon.” It’s important that we meet their underlying fears, needs and expectations. For example, if someone has trouble walking, and recalls a doctor addressing this with them, it may be useful to suggest that the doctor wants them to “stay there until the physical problem has healed.”

• “Don’t you remember…?” - We only want to ask someone with dementia if they remember something from a long time ago. We want to tap into that long-term memory for communication purposes, not relying on things that happened in the last decade, or even in the last couple hours. We especially do not want to use this phrase when we’re frustrated. For example, responding to your loved one in an exasperated tone, “Don’t you remember! I just told you that we were going to lunch at 12:30!” is not very kind. They do not remember, so a better tactic would be to take a deep breath, center yourself and then answer, “We’re going to lunch at 12:30.”

• “You have dementia/you have a memory problem.” - These are never good statements to offer someone living with dementia. Instead of reminding someone that they are confused, avoid it altogether. There is no reason to tell someone that their judgment is off, or that they did something that didn’t make sense to you. It won’t help you win an argument and it certainly won’t make them happy!

• “Your mom died years ago.” - Never remind someone that they’ve lost a loved one. Instead, find out where they think that person is. When she asks, “Where’s my mom?” respond with a question. “Where do you think she is?” you can ask. Her answer is your answer: it takes you off the hook from having to come up with something to say. “That sounds right,” you offer. “She must be…” and then fill in the blank with whatever she said.

We always want to make sure that we’re keeping our interactions with people who have dementia very positive and in-their-reality. All of these statements have a positive, flip side that we can use. Learn more about strategies for more effectively communicating with dementia patients.